You can't believe you ate the whole thing. But you did. All seven courses. Then you had two helpings of dessert. Then, to be social, you had a couple of drinks. Or maybe three or four.

And now you're paying for it. You've got a "burning sensation" in your stomach or your chest, or maybe you feel all knotted up inside.

Your first reaction may be to reach for your favorite antacid to make the hurting go away. And if you do, you won't be alone.

Americans are currently spending close to $1 billion per year on these popular, over-the-counter drugs. Used according to directions and in moderation, they can quickly relieve the symptoms associated with occasional heartburn and indigestion. But these useful products may not always be necessary, and they have their dark side if used improperly.

"Improperly" means taking too much of an antacid over a short period, or using antacids frequently over a long period (weeks, months or years). Frequent and prolonged use of these products can cause irreparable harm to your heart, kidneys or bones.

Even if used occasionally and in moderation, antacids can mean bad news for people with special medical conditions.

Hugo Gallo-Torres, M.D., a medical officer with FDA's Center for Drug Evaluation and Research, said it's a good idea to consult your doctor before using antacids if you:

• are on any kind of medication
• are pregnant or breast-feeding
• have kidney problems
• have chronic constipation, diarrhea or colitis
• have stomach or intestinal bleeding
• have an irregular heartbeat
• have any kind of chronic illness
• have symptoms that may indicate appendicitis.

Though they cause problems for some, most people can take antacids without worrying. Consumers who use them only once in a while, and as directed, are unlikely to experience significant side effects.

But, like most everything else in life, moderation is the key.

"Antacids are useful drugs — they serve a purpose," said Gallo-Torres. "Ideally, though, it's always better to try dealing with heartburn and indigestion — at least initially — without taking any medications at all, or by avoiding trouble in the first place."

Gallo-Torres said there are some simple steps you can take that may help prevent heartburn or indigestion.

Don't eat big meals. Your stomach has to work long and hard to process them, which means it has to produce a lot of acid. It helps to eat more frequent — but smaller — meals.

Eat more slowly. Downing a lot of food in a hurry can overwhelm your stomach, which responds by producing extra digestive acids.

After you eat, don't lie down right away. If you do, you're more likely to have heartburn, because gravity is now preventing food from going speedily to the intestines. It's also a good idea to eat your last big meal at least three hours before bedtime. When you go to sleep, everything slows down, including your digestive system, so food you've eaten right before bedtime will stay in your stomach longer. It won't feel good.

Don't wear tight-fitting garments. They can literally compress your stomach, making it more likely that the stomach's acid contents will enter your esophagus and cause a burning sensation.

Cut down on caffeine; it makes your stomach produce more acid. Caffeine-heavy items include coffee, tea, chocolate, and some sodas.

Avoid foods that contain a lot of acid, such as citrus fruits and tomatoes, and any other food that gives you problems.

Cut back on alcohol and smoking. Both irritate the lining of your stomach and both tend to lower esophageal sphincter pressure. When this happens, it's easier for the contents of your stomach to shoot back up into your esophagus.

Sleep with your head and shoulders propped up six to eight inches, so that your body is at a slight angle. This gets gravity working for you and not against you, and the digestive juices in your stomach are more likely to head south, for your intestine, instead of back up into your esophagus.

"If you do take an antacid, remember that what you're taking is a drug," Gallo-Torres said. "It is a drug that, in the vast majority of cases, should be used only for occasional relief of mild heartburn or indigestion. Antacids are fast-acting. They should bring relief within minutes. If you're taking antacids and there's no relief, then something else may be going on, something that requires a physician's evaluation."

Igor Cerny, a pharmacist with FDA's Center for Drug Evaluation and Research, agreed. "If you find yourself taking antacids frequently," he said, "you need to say to yourself: 'Wait a minute.... I wasn't doing this before, so why am I doing it now? Something might be wrong with me.'

"If your symptoms last more than two weeks, go see your doctor," he recommended. "Two weeks is the general rule of thumb. Beyond that, taking antacids can actually mask a more serious medical problem."

Cerny said it's a good idea to see your doctor even sooner — preferably right away — if you're experiencing any symptoms severe enough to interfere with your lifestyle, symptoms such as continuous vomiting or diarrhea, extreme discomfort or pain in your gastrointestinal (GI) tract, vomiting of blood or material that looks like coffee grounds (but which is actually digested blood), or any of these accompanied by fever.

"Using antacids to alleviate serious symptoms like these is like trying to put out a building fire with a hand-held extinguisher," Cerny said. "Serious symptoms require professional evaluation and treatment."

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Tags: Health, Medicine

About the Author

FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.